1000 resultados para Medically Undeserved Areas


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The focus of this paper is on two World Heritage Areas: the Great Barrier Reef in Queensland, Australia and the Everglades in Florida. While both are World Heritage listed by the UNESCO, the Everglades is on the "World Heritage in Danger" list and the Great Barrier Reef could be on this list within the next year if present pressures continue. This paper examines the planning approaches and governance structures used in these two areas (Queensland and Florida) to manage the growth and development pressures. To make the analysis manageable, given the scale of these World Heritage areas, case studies at the local government level will be used: the Cairns Regional Council in Queensland and Monroe County in Florida. The case study analysis will involve three steps: (1) examination of the various plans at the federal, state, local levels that impact upon environmental quality in the Great Barrier Reef and Everglades; (2) assessing the degree to which these plans have been implemented; and (3) determine if (and how) the plans have improved environmental quality. In addition to the planning analysis we will also examine the governance structures (Lebel et al. 2006) within which planning operates. In any comparative analysis context is important (Hantrais 2009). Contextual differences between Queensland and Florida have previously been examined by Sipe, et al. (2007) and will be used as the starting point for this analysis. Our operating hypothesis and preliminary analysis suggests that the planning approaches and governance structures used in Florida and Queensland are considerably different, but the environmental outcomes may be similar. This is based, in part, on Vella (2004) who did a comparative analysis of environmental practices in the sugar industry in Florida and Queensland. This research re-examines this hypothesis and broadens the focus beyond the sugar industry to growth and development more broadly.

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Background Injury is the leading cause of adolescent death and injury around the road is a common source of adolescent injuries. Skills for Preventing Injury in Youth (SPIY) is a comprehensive program developed in Australia for early adolescents (term-long curriculum, including looking out for friends, first-aid training coupled with teacher school-connectedness professional development). Jessors’ Protection-Risk Framework guided the program approach focusing on building protective relationships. Method A randomized controlled trial with 35 schools was undertaken. Students completed surveys at baseline, six-months post-intervention and twelve-months post intervention. There were 1686 students (56% female) who completed the twelve-month survey, including the Extended-Adolescent Injury Checklist whereby students self-report on medically-treated injuries over the previous three-months (only road-related items are reported in this study; cycling, motorcycle riding, pedestrian, and riding as a passenger). Randomly selected SPIY classes also participated in focus groups and reported on perceptions of SPIY and injury risk behavior. Results As a check of randomization baseline differences of the variables were examined, with no significant differences between intervention and control groups. At the 12-month follow-up, there were fewer medically-treated injuries among the intervention students compared with the control group, particularly associated with being a passenger. The process evaluation revealed students perceived change in injury risk and risk behaviors. Conclusions While data analyses are continuing, the results indicate that the program seeking to encourage adolescents to look out for their friends, build connections to school and provide first aid skills training goes some way to reducing self-reported medically-treated injuries around the road.

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There are limited community-based data on the burden of influenza and influenza-like illnesses during pregnancy to inform disease surveillance and control. We aimed to determine the incidence of medically-attended respiratory illnesses (MARI) in pregnant women and the proportion of women who are tested for respiratory pathogens at these visits. We conducted a nested retrospective cohort study of a non-random sample of women aged ≥18 years who had a live birth in maternity units in Brisbane, Queensland, from March 2012 to October 2014. The primary outcomes were self-reported doctor visits for MARI and laboratory investigations for respiratory pathogens. Descriptive analyses were performed. Among 1202 participants, 222 (18.5%, 95%CI 16.3%-20.7%) self-reported MARI during their pregnancy. Of those with an MARI, 20.3% (45/222) self-reported a laboratory test was performed. We were able to confirm with health service providers that 46.7% (21/45) of tests were undertaken, responses from providers were not received for the remainder. Whilst one in five women in this population reported a MARI in pregnancy, only 3.7% (45/1202) reported a clinical specimen had been arranged at the consultation and the ability to validate that self-report was problematic. As the focus on maternal immunisation increases, ascertainment of the aetiological agent causing MARI in this population will be required and efficient and reliable methods for obtaining those data at the community level need to be established.

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he composition and relative abundance of airborne pollen in urban areas of Australia and New Zealand are strongly influenced by geographical location, climate and land use. There is mounting evidence that the diversity and quality of airborne pollen is substantially modified by climate change and land-use yet there are insufficient data to project the future nature of these changes. Our study highlights the need for long-term aerobiological monitoring in Australian and New Zealand urban areas in a systematic, standardised, and sustained way, and provides a framework for targeting the most clinically significant taxa in terms of abundance, allergenic effects and public health burden.

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Background Understanding the relationship between extreme weather events and childhood hand, foot and mouth disease (HFMD) is important in the context of climate change. This study aimed to quantify the relationship between extreme precipitation and childhood HFMD in Hefei, China, and further, to explore whether the association varied across urban and rural areas. Methods Daily data on HFMD counts among children aged 0–14 years from 2010 January 1st to 2012 December 31st were retrieved from Hefei Center for Disease Control and Prevention. Daily data on mean temperature, relative humidity and precipitation during the same period were supplied by Hefei Bureau of Meteorology. We used a Poisson linear regression model combined with a distributed lag non-linear model to assess the association between extreme precipitation (≥ 90th precipitation) and childhood HFMD, controlling for mean temperature, humidity, day of week, and long-term trend. Results There was a statistically significant association between extreme precipitation and childhood HFMD. The effect of extreme precipitation on childhood HFMD was the greatest at six days lag, with a 5.12% (95% confident interval: 2.7–7.57%) increase of childhood HFMD for an extreme precipitation event versus no precipitation. Notably, urban children and children aged 0–4 years were particularly vulnerable to the effects of extreme precipitation. Conclusions Our findings indicate that extreme precipitation may increase the incidence of childhood HFMD in Hefei, highlighting the importance of protecting children from forthcoming extreme precipitation, particularly for those who are young and from urban areas.

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This chapter provides an overview of the Japanese regulatory issues regarding pesticide use in rice paddies and an introduction of the new pesticide registration program. In addition, the experience of the environmental monitoring of pesticides and the modeling approaches used for the calculation of predicted environmental concentrations (PECs) in surface water and ground water systems adjacent to rice paddies in Japan are also discussed. Japan has been one of the major pesticide users in the world. Although having a long history in rice cultivation, the pesticide exposure assessment for paddy rice production received less attention compared with EU and US. Applications of up-to-date techniques and the development of realistic assessment procedures under specific climatic conditions as well as mitigation management practices for controlling pesticide contamination are important for an environmental-friendly rice production. Through the international cooperation and research exchanges, advances in pesticide risk assessment for rice paddies in Asian region and other rice-growing areas in the world would contribute to sustainable rice production. Transplanting of rice seedlings grows almost all rice paddies in Japan. The land preparation starts around April and June, and the harvest season lasts from August to October depending on the region and the rice varieties. Most of the rice paddies are treated with herbicides and other crop protection products, such as fungicides and insecticides that are applied during the crop season accordingly. Newly developed insecticides and fungicides are also applied during seedbed preparation.

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A double antibody sandwich enzyme linked immunosorbent assay (ELISA) was developed to detect Echis carinatus venom in various organs (brain, heart, lungs, liver, spleen and kidneys) as well as tissue at the site of injection of mice, at various time intervals (1, 6, 12, 18, 24 h and 12 h intervals up to 72 h) after death. The assay could detect E. carinatus venom levels up to 2.5 ng/ml of tissue homogenate and the venom was detected up to 72 h after death. A highly sensitive and species-specific avidin-biotin microtitre ELISA was also developed to detect venoms of four medically important Indian snakes (Bungarus caeruleus, Naja naja, E. carinatus and Daboia russelli russelli) in autopsy specimens of human victims of snake bite. The assay could detect venom levels as low as 100 pg/ml of tissue homogenate. Venoms were detected in brain, heart, lungs, liver, spleen, kidneys, tissue at the bite area and postmortem blood. In all 12 human victim cadavers tested the culprit species were identified. As observed in mice, tissue at the site of bite area showed the highest concentration of venom and the brain showed the least. Moderate amounts of venoms were found in liver, spleen, kidneys, heart and lungs. Development of a simple, rapid and species-specific diagnostic kit based on this ELISA technique useful to clinicians is discussed.

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Background Motivation is an important driver for health professionals to maintain professional competencies, continue in a workforce and contribute to work tasks. While there is some research about motivation in health workers in low to middle income countries, maternal morbidity and mortality remains high in many low and middle income countries and this can be improved by improving the quality of maternal services and the training and skills maintenance of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods. Methods The study consisted of a survey using a self-administered questionnaire of 240 health workers in 5 districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23 item motivation instrument based on Kenyan health context, modified for Vietnamese language and culture. Results The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = -0.14, p=0.03), ability to perform key tasks (β = 0.22, p=0.001), and shift schedule (β = -0.13, p=0.05). Motivation was higher in health workers self-identifying as competent or enabled to provide more care activities. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to motivation. Conclusions The study demonstrates the importance of understanding the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low and middle income countries.

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Climate matching software (CLIMEX) was used to prioritise areas to explore for biological control agents in the native range of cat's claw creeper Macfadyena unguis-cati (Bignoniaceae), and to prioritise areas to release the agents in the introduced ranges of the plant. The native distribution of cat's claw creeper was used to predict the potential range of climatically suitable habitats for cat's claw creeper in its introduced ranges. A Composite Match Index (CMI) of cat's claw creeper was determined with the 'Match Climates' function in order to match the ranges in Australia and South Africa where the plant is introduced with its native range in South and Central America. This information was used to determine which areas might yield climatically-adapted agents. Locations in northern Argentina had CMI values which best matched sites with cat's claw creeper infestations in Australia and South Africa. None of the sites from where three currently prioritised biological control agents for cat's claw creeper were collected had CMI values higher than 0.8. The analysis showed that central and eastern Argentina, south Brazil, Uruguay and parts of Bolivia and Paraguay should be prioritised for exploration for new biological control agents for cat's claw creeper to be used in Australia and South Africa.

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Objective: To investigate the prevalence of Echinococcus granulosus in wild dogs (dingos and dingo-domestic dog hybrids) living in and around human habitation on Fraser Island and in townships of the Maroochy Shire, on Queensland's Sunshine Coast, Australia. Design: Wild dogs were humanely killed on Fraser Island and in the Maroochy Shire because they were deemed a potential danger to the public. Their intestines were collected and the contents examined for intestinal parasites. Procedure: Intestines were removed as soon after death as possible, packed in plastic bags and kept frozen until examination. The intestinal contents were washed, sieved and examined microscopically for the presence of helminths, which were identified and counted. Results: Intestines from 108 wild dogs, 7 foxes and 18 Fraser Island dingoes were examined. Echinococcus granulosus was only present in the wild dogs from Maroochy Shire (46.3%) with worm burdens of between 30 and 104,000. Other helminths included Spirometra erinacei, Dipylidium caninum, Taenia spp., Ancylostoma caninum and Toxocara canis. Two specimens of a trematode (Haplorchinae sp.) usually found infecting fish and seabirds were recovered from a Fraser Island dingo. Conclusion: Dingoes on Fraser Island are not infected with E. granulosus and do not pose a hydatid disease public health risk to residents or visitors. However, wild dogs examined from the Maroochy Shire do present a potential hydatid disease public health risk.

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For pasture growth in the semi-arid tropics of north-east Australia, where up to 80% of annual rainfall occurs between December and March, the timing and distribution of rainfall events is often more important than the total amount. In particular, the timing of the 'green break of the season' (GBOS) at the end of the dry season, when new pasture growth becomes available as forage and a live-weight gain is measured in cattle, affects several important management decisions that prevent overgrazing and pasture degradation. Currently, beef producers in the region use a GBOS rule based on rainfall (e. g. 40mm of rain over three days by 1 December) to define the event and make their management decisions. A survey of 16 beef producers in north-east Queensland shows three quarters of respondents use a rainfall amount that occurs in only half or less than half of all years at their location. In addition, only half the producers expect the GBOS to occur within two weeks of the median date calculated by the CSIRO plant growth days model GRIM. This result suggests that in the producer rules, either the rainfall quantity or the period of time over which the rain is expected, is unrealistic. Despite only 37% of beef producers indicating that they use a southern oscillation index (SOI) forecast in their decisions, cross validated LEPS (linear error in probability space) analyses showed both the average 3 month July-September SOI and the 2 month August-September SOI have significant forecast skill in predicting the probability of both the amount of wet season rainfall and the timing of the GBOS. The communication and implementation of a rigorous and realistic definition of the GBOS, and the likely impacts of anthropogenic climate change on the region are discussed in the context of the sustainable management of northern Australian rangelands.

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Selection of biocontrol agents that are adapted to the climates in areas of intended release demands a thorough analysis of the climates of the source and release sites. We present a case study that demonstrates how use of the CLIMEX software can improve decision making in relation to the identification of prospective areas for exploration for agents to control the woody weed, prickly acacia Acacia nilotica ssp. indica in the arid areas of north Queensland.

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We used an established seagrass monitoring programme to examine the short and longer-term impacts of an oil spill event on intertidal seagrass meadows. Results for potentially impacted seagrass areas were compared with existing monitoring data and with control seagrass meadows located outside of the oil spill area. Seagrass meadows were not significantly affected by the oil spill. Declines in seagrass biomass and area 1 month post-spill were consistent between control and impact meadows. Eight months post-spill, seagrass density and area increased to be within historical ranges. The declines in seagrass meadows were likely attributable to natural seasonal variation and a combination of climatic and anthropogenic impacts. The lack of impact from the oil spill was due to several mitigating factors rather than a lack of toxic effects to seagrasses. The study demonstrates the value of long-term monitoring of critical habitats in high risk areas to effectively assess impacts.

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Context. Irregular plagues of house mice cause high production losses in grain crops in Australia. If plagues can be forecast through broad-scale monitoring or model-based prediction, then mice can be proactively controlled by poison baiting. Aims. To predict mouse plagues in grain crops in Queensland and assess the value of broad-scale monitoring. Methods. Regular trapping of mice at the same sites on the Darling Downs in southern Queensland has been undertaken since 1974. This provides an index of abundance over time that can be related to rainfall, crop yield, winter temperature and past mouse abundance. Other sites have been trapped over a shorter time period elsewhere on the Darling Downs and in central Queensland, allowing a comparison of mouse population dynamics and cross-validation of models predicting mouse abundance. Key results. On the regularly trapped 32-km transect on the Darling Downs, damaging mouse densities occur in 50% of years and a plague in 25% of years, with no detectable increase in mean monthly mouse abundance over the past 35 years. High mouse abundance on this transect is not consistently matched by high abundance in the broader area. Annual maximum mouse abundance in autumn–winter can be predicted (R2 = 57%) from spring mouse abundance and autumn–winter rainfall in the previous year. In central Queensland, mouse dynamics contrast with those on the Darling Downs and lack the distinct annual cycle, with peak abundance occurring in any month outside early spring.Onaverage, damaging mouse densities occur in 1 in 3 years and a plague occurs in 1 in 7 years. The dynamics of mouse populations on two transects ~70 km apart were rarely synchronous. Autumn–winter rainfall can indicate mouse abundance in some seasons (R2 = ~52%). Conclusion. Early warning of mouse plague formation in Queensland grain crops from regional models should trigger farm-based monitoring. This can be incorporated with rainfall into a simple model predicting future abundance that will determine any need for mouse control. Implications. A model-based warning of a possible mouse plague can highlight the need for local monitoring of mouse activity, which in turn could trigger poison baiting to prevent further mouse build-up.

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Wild carnivores are becoming increasing common in urban areas. In Australia, dingoes exist, in most large cities and towns within their extended range. However, little empirical data is available to inform dingo management or address potential dingo–human conflicts during urban planning. From GPS tracking data, the nine dingoes, predominately juvenile and female, we tracked lived within 700 m of residential homes at all times and frequently crossed roads, visited backyards and traversed built-up areas. Home range sizes ranged between 0.37 km2 and 100.32 km2. Dingoes were mostly nocturnal, averaging 591 m/h between dusk and dawn. Juvenile and adult dingoes spent up to 19% and 72% of their time in urban habitats. Fresh scats from most areas surveyed tested positive to a variety of common zoonoses. These data suggest dingoes are capable of exploiting peri-urban areas and might contribute to human health and safety risks, the significance of which remains unknown.